Shadowing experiences

[DrQuinnMW]

I am a pre-med student and recently shadowed a MD in the ER. While watching him suture a 2 inch gash on a man's forehead, I became really dizzy, my vision got blurry, and I felt weak with a cold sweat. I have never passed out before, but I felt like that was what was close to happening. The thing is, I wasn't "grossed out" at all. I thought it was really neat to see him work and nothing else to that point in the shadow experience made me feel grossed out or like I couldn't handle the "blood and guts."

Does any one else have a similar experience? The thing that worried me was that I felt like I didn't have any control over that response, since nothing I had seen was upsetting to me. I plan on going back and don't want to have the same thing happen again. Anyone have any tips or tricks?

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[spicedmanna]

I am a pre-med student and recently shadowed a MD in the ER. While watching him suture a 2 inch gash on a man's forehead, I became really dizzy, my vision got blurry, and I felt weak with a cold sweat. I have never passed out before, but I felt like that was what was close to happening. The thing is, I wasn't "grossed out" at all. I thought it was really neat to see him work and nothing else to that point in the shadow experience made me feel grossed out or like I couldn't handle the "blood and guts."

Does any one else have a similar experience? The thing that worried me was that I felt like I didn't have any control over that response, since nothing I had seen was upsetting to me. I plan on going back and don't want to have the same thing happen again. Anyone have any tips or tricks?

Don't worry about it; ain't no thang. You had a vasovagal reaction, leading to a near-syncopal episode. You probably exacerbated your reaction by hyperventilating on top of it. It has been my experience that when most people first encounter such instances of "blood and guts", although they tend to get used to it quickly, they are on that edge of visceral disgust and strange fascination. Some are more lateralized to one extreme than the other. I think it's a fairly normal bodily reaction; something you can't really control. We don't know why it happens, but it's something you can accomodate to through time and experience, as long as there isn't any underlying pathology.

I had a similar reaction when I scrubbed in on my first surgery. I first-assisted on a femoral artery cannulation procedure and was using the bovie to dissect and remove some of the old adhesions. Ah, nothing like the fresh, acrid, yet sweet, smell of burning flesh. I started to feel hot and was getting pretty diaphoretic. One of the nurse-assistants noticed and invited me to sit down, but I refused thinking I could push through it. I got dizzy and lightheaded. I had to sit down. After that, I got used to it. I scrubbed in on countless similar procedures and it wasn't that big of a deal.

Don't worry about it. If you don't feel some kind of, "wow, this is kind of heavy," when you have a patient in your hands, that's when you need to worry.

Tips? Yeah, breathe normally; stay adequately hydrated (being dehydrated can exacerbate a vasovagal reaction). Take a moment when you need to. Feel all your feelings and move on ahead. You'll get sort of used to it in time.

 

[Chunkeroni]

very good tips. working at a camp for kids with illnesses in the summer I have seen lots of "blood and guts' sorts of things and the just plain disgusting. I am not squeamish at all, i have had countless stitches for various accident-prone injuries and watched them put em in. But I remember the first time I watched a kid self-infuse (which isn't actually very blood and guts at all) I got a little dizzy etc. and had to excuse myself for a second, but I was not grossed out at all, I couldn't really understand what was happening to me. So you are not alone in this feeling. I definitely got used to it and have even gotten the chance to infuse some of my blood-disordered coworkers. : )

 

[grinchick5]

You had a vasovagal reaction, leading to a syncopal episode.

Nice to know there’s a name for it.

I felt like a complete idiot when I broke into a heavy sweat and almost passed out while observing a colonoscopy/polypectomy. Also, my vision totally went…everything was blurry. Yet, I wasn’t consciously grossed out at all.

 

[avalon18217]

It's good to hear that this has happened to other people. I was also just watching sutures (which I had seen several times before) while I was volunteering in the ED. I noticed I was feeling like I would faint and had to sit down. I still fainted in the chair, and hit my head pretty good, (scared the nurses).
I had fainted several times when I was younger, and I noticed that for me anything getting my heart rate high enough would do it (including seeing the neurologist).
I'm not sure if I was that excited about the suture, but the PA there said I may have just been locking my knees. I tried to tell people that I was not upset by what I had seen, but I'm not sure they believed me.

 

[spicedmanna]

I'm not sure if I was that excited about the suture, but the PA there said I may have just been locking my knees. I tried to tell people that I was not upset by what I had seen, but I'm not sure they believed me.

Yeah, that's a possibility. There are a few factors at play, here, really. However, when you stand up for a long period of time, your blood flow has to fight against gravity, so it tends to pool in at your legs/feet. This is generally not a concern, but if you are hypovolemic/dehydrated, or if you are actively vasodilating (increases the size of the vascular "container"), this could cause you to faint. If you lock your knees, you can exacerbate the pooling of the blood. Locking your knees allows your skeletal structure to take a large portion of your body weight, so your leg muscles don't need to work as hard to keep you standing. The contraction of leg muscles usually aids in the maintenance of proper circulation, so if you aren't engaging them actively, blood will pool more readily, especially if you've been standing for awhile. Thus, you are more likely to feel faint. Move around some when you think of it and definitely don't lock your knees if you are standing for a long period of time.

 

[NickRiviera]

Some rooms are negative pressure airflow isolation rooms, especially in ERs. They keep bad stuff from getting into other rooms. Someone I worked with would either pass out or almost pass out when they spent any time in these rooms. Might also be something to think about.

 

[AAhopeful]

I had a very similar experience. When my wife had her c-section the wound did not heal correctly. The first time we went into the doctor's office they had to open it back up. This was my first time seeing something like that. I felt the exact same way you did, I really wanted to look but at the same time I could hardly control what was happening. After that incident though, I flushed and repacked the wound twice a day for about 6 or so weeks with no problems at all. It is not like I could just do it without looking either. The nurse that would come out to the house and change it twice a week made sure I noted the color of the walls, depth, moisture, color of packing material, and other stuff when ever I changed the packing. It was interesting for me; my wife didn't care for it too much though.

 

[AustinFinklea]

I was shadowing my doc (joint replacement orthopod) and a 4th year from the Univ. of Utah passed out and knocked his head on a gear cart and ended needing 20 or so stitches.....It was unreal.

 

[sharencare]

I am so glad i am not the only one that this happened to. Even though everybody has told me its pretty common, i still felt pretty stupid when it actually happened to me. So i've seen a good amount of blood and guts before, observed a spinal tap, sutures, been in the OR while shadowing a doc, etc. But this 1 time i went to shadow 1 of the top cardiologists here- who had agreed to let me shadow him after a lot of pleading. I was with him on his rounds. Visited a few patients on a few different floors- he believed in taking stairs everywhere and so i did the same, I believe i was a little dehydrated and then we went into a patient's room where he told him he was probably going to die soon and then we came out. Next thing i know i am getting light headed and diaphoretic and i am like can a sit for a second and then bam- i am on the floor in the hallway.The nurses and the doctors and the med students are around me and i can hear them but my vision is too blurry. 5 minutes later i am absolutely fine. But that was nonetheless the end of my shadowing day- I was asked to go back and come when it was "less stressful".
Not to say i felt and to this day feel stupid for that.